Intrauterine infection may be a major cause of stillbirth in Sweden

Acta Obstet Gynecol Scand. 2001 Jun;80(6):511-8.


Aim of the study: To investigate intrauterine infection as a cause for unexplained stillbirth.

Methods: Chorioamnionitis was studied in a material of stillbirths (117 subjects from the years 1985-1994) from a region in the south Sweden. Control material (126 alive and healthy newborns and with healthy mothers) was gathered from the same region.

Results: Chorioamnionitis was a common diagnosis both with stillbirths and 'healthy' deliveries (82 and 68%, respectively). Extension of the inflammation to decidua basalis was seven times more common among stillbirths than among controls (odds ratio 7.2, confidence interval 2.8-21.9). The most common bacteria found at cultures were Escherichia coli, Coagulase negative staphylococcus, Enterococcus faecalis and group B Streptococcus. The risk for stillbirth was doubled if both inflammation and bacteria were present (odds ratio 2.3, confidence interval 0.92-5.8). Meconium discharge was more common among stillbirths than controls (odds ratio=4.7, confidence interval 1.7-14). There were no differences in any respect regarding macerated and non-macerated stillbirths. Our findings are similar to the results from studies in developing countries except for the higher incidence of stillbirths in such countries.

Conclusions: Thus, a large part of otherwise unexplained stillbirths might be due to ascending infections.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Bacterial Infections / epidemiology
  • Bacterial Infections / microbiology
  • Case-Control Studies
  • Chorioamnionitis / epidemiology*
  • Chorioamnionitis / microbiology
  • Comorbidity
  • Confidence Intervals
  • Culture Techniques
  • Female
  • Fetal Death / epidemiology*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Incidence
  • Infant, Newborn
  • Odds Ratio
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / epidemiology*
  • Probability
  • Reference Values
  • Retrospective Studies
  • Risk Factors
  • Sweden / epidemiology